Bridging across the ampulla with metal stents: evidences for intestinal bile reflux.

BACKGROUND/AIMS: To investigate the early intestinal bile reflux following the implantation of metal stent across the ampulla and the mechanism of reflux cholangitis.

METHODOLOGY: Twenty-three patients with implantation of metal stent across the ampulla were recruited. Prior to the implantation, the white blood cell count, neutrophil percentage, total blood bilirubin, direct bilirubin and the trypsin content in the bile were recorded; 2-5 days after implantation these indices were measured again, as well as the 99mTc -DTPA radioactivity.

RESULTS

A high percentage (82.61%) of patients showed 99mTc in the bile in 2 hours, which accounts for 1.73% of total intake. In 4 cases the radioactivity was not found. Bile lipase and amylase levels were significantly higher than that in prior to the stent implantation. There were no changes in the white blood cell count and neutrophil percentage after stent implantation. Additionally, the total blood bilirubin and direct bilirubin decreased.

CONCLUSIONS

After the implantation of metal stent across the ampulla, there is evidence for the early intestinal bile reflux, without signs for the reflux cholangitis.